The aim of this study is to assess the role of ultrasound (US),using 2, 3 and 4D techniques and Doppler study, and emphasize the complementary role of MRI in genito-urinary anomalies. Fifty four pregnant were included in this study, the maternal age range was 19-35 years. The gestational age range was 18-36 weeks. Cases with suspected renal anomalies were included regardless the amount of amniotic fluid . US was done full 2D (combined gray-scale and color Doppler studies) and 3D pelvic Ultrasound evaluation was done in all cases, MRI was done for thirty pregnant within one week of US examination, MRI was not done in 24 cases (44.4%), 5 of them were of simple pathology : unilateral ovarian cyst in 3cases and simple renal cyst was detected in 2 cases. The other 18 from the 24 cases refused to do MRI and US images were diagnostically satisfactory. Two cases of bilateral multicystic kidneys (MCDK) , 2 cases of unilateral MCDK and renal agenesis (RA) in other kidney, and 5 cases with bilateral hydronephrosis and hydroureters due to posterior urethral valve stenosis (PUV) , one case trisomy 18 and one case trisomy 13, and 2 cases of Meckle Gruber Syndrome (MGS) and 3 cases of autosomal recessive polycystic kidney disease (ARPKD), 2 cases of bilateral RA with Hydrops fetalis and cystic hygroma. Genital abnormalities were detected in only 4cases (7.4%), three cases with unilateral simple ovarian cyst, and one case of hydrometrocolpus. MRI confirms the findings of utrasonography in 23 cases (76.66%) and altered the diagnosis regarding the urinary system in five cases (16.66%). Ultrasound was superior to MRI in two cases (6.66%). Therefore 2D grey scale US is the stander protocol for those fetuses in which malformations are already determined or suspected on the basis of standard sonography.